10 July 2020 05:01 AM

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SUNIT MEDIRATTA | 2 JUNE, 2020

The New Crisis Lurking Behind Lockdown Relaxation

The situation clearly reflects the dwindling interest of the authorities


State governments have started easing the lockdown and our worst fears are coming true. At the time of writing India had recorded the highest single-day spikes in 4 of the last 7 days, with more than 6,000 cases being reported every day since May 22.

Almost every day Delhi is hitting record high numbers and similar trends are emerging in Mumbai. This obviously means we are failing in our social responsibilities.

Shocking incidents are emerging from Bengaluru where municipal corporation officials have been seen accepting bribes from Covid positive patients to let them go free from the quarantine centres. People in quarantine centres in cities with poor facilities have been regularly attempting to escape, with many even succeeding in doing so.

The official data and statistical graphs released by NITI Aayog on the progress of the pandemic are being mocked by scientists, as they had projected a downward trend by mid-May. They have not shared with the public how they arrived at such conclusions and what methods were used for the epidemiological graph, observes V.Guttal, a professor at the Indian Institue of Science, Bengaluru.

This clearly reflects the dwindling interest of the authorities.

The sharp spike in the absolute number of cases is being reflected in hospital bed occupancy figures. In the two worst affected cities of Mumbai and Delhi, within days of the governments’ opening up restrictions many Covid designated hospitals are already full to capacity, and there is a waiting period of nearly 3 to 5 days for patients needing ICU admissions.

All this after many private sector hospitals have been taken over by the government and converted into Covid treatment centres.

Many private labs in Delhi have a waiting period of 3 to 5 days for home collection of samples for Covid testing — this gives an idea of the searing numbers.

With the rising number of cases, the Maharashtra government made it mandatory for private doctors in Mumbai to work in a Covid treatment centre for 15 days. But private doctors there have many concerns regarding their safety, and the mandatory quarantine on completing 15 days’ work.

With nothing being put on record and by making private doctors sign up for voluntary work, the government directive hasn’t been received well within the medical community.

This may well be the fate of doctors in other cities once the numbers rise further.

With its restrictive and narrowing criteria for testing, the government simply isn’t testing enough people and there aren’t an adequate number of private labs authorised to test for Covid. The cost of testing fixed by the government — the price cap of Rs 4,500 was recently removed by the ICMR — is clearly out of reach for most people who are struggling to make ends meet.

With the sensitivity of the test being 70 to 90 percent it means many will have to be tested again to confirm they have the infection. Two negative test results obtained one week apart certify a patient as cured.

The government’s Make in India slogan needs to be seriously implemented, swiftly, and our testing kits should be manufactured locally rather than importing from China if costs are to be brought down.

The testing rate in India is 1,777 tests per million populations which is among the lowest in the world. We need to speed up our testing and start opening up more private labs to allow testing to be done.

Antigen and antibody tests will be able to diagnose ongoing infections and past (recovered) infections respectively. This data will help open up economic activity based on red, orange and green zones derived from reliable and widespread testing.

Without knowing the true extent of the infection we are unlikely to bring it under control. This makes testing even more important because forewarned is forearmed.

The healthcare situation is likely to get out of hand once restrictions on mobility are removed. We had better gear up.

Dr Sunit Mediratta is a consultant neurosurgeon at the Apollo Hospital, New Delhi
 

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